neurocognitive disorders

神经认知障碍
  • 文章类型: Journal Article
    处理速度(SOP)认知训练可能会改善艾滋病毒感染者的生活质量(QoL)指标。在这两年里,纵向,随机化,对照试验,216名年龄在40岁及以上的HIV相关神经认知障碍或边缘HIV相关神经认知障碍的参与者被分配到三组中的一组:(a)10小时的SOP训练(n=70);(b)20小时的SOP训练(n=73),或(c)10小时的互联网导航控制培训(一个联系控制组;n=73)。参与者在基线时完成了几项QoL测量,后测,以及第一年和第二年的随访。使用线性混合效应模型,在QoL结果中没有明显的训练效应模式,小幅度,不显著,抑郁症的组间差异,控制源,和医学成果研究-HIV量表。总之,尽管之前的工作显示SOP认知训练的一些转移改善了QoL,这没有被观察到。提出了对研究和实践的启示。
    UNASSIGNED: Speed of processing (SOP) cognitive training may improve indicators of the quality of life (QoL) in people living with HIV. In this 2-year, longitudinal, randomized, controlled trial, 216 participants ages 40 years and older with HIV-associated neurocognitive disorder or borderline HIV-associated neurocognitive disorder were assigned to one of three groups: (a) 10 hr of SOP training (n = 70); (b) 20 hr of SOP training (n = 73), or (c) 10 hr of internet navigation control training (a contact control group; n = 73). Participants completed several QoL measures at baseline, posttest, and Year 1 and Year 2 follow-ups. Using linear mixed-effect models, no strong pattern of training effects across QoL outcomes was apparent, with small-magnitude, nonsignificant, between-group differences in depression, locus of control, and Medical Outcomes Study-HIV scales. In conclusion, despite prior work showing some transfer of SOP cognitive training improving QoL, that was not observed. Implications for research and practice are posited.
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  • 文章类型: Journal Article
    背景:支持就地老化,生活质量和活动参与是痴呆症患者的公共卫生优先事项,但是对社区居民的需求和经验知之甚少,这些人患有罕见的痴呆症,症状较少。后皮质萎缩(PCA)是一种罕见的痴呆形式,通常由阿尔茨海默病引起,但其特征是视觉处理减少(而不是主要的记忆问题)。这对保持独立性和获得适当支持构成了挑战。
    方法:本研究采用了比较定性设计和集中的人种学方法,以探索10位最常见,以记忆为主导的阿尔茨海默病和10名患者在日常家庭环境中患有后皮质萎缩。
    结果:虽然数据收集显示了个体和背景因素的丰富差异,可以消除日常活动经验中的一些初步高层差异,似乎归因于不同的诊断\'不同的主要症状。这些包括后皮质萎缩的人不太可能使用环境线索来启动活动,并且更有可能拒绝寻求支持,因为保留了对护理者影响的洞察力。这种缺乏活动的启动可能会被误解为冷漠。患有后皮质萎缩的人也被劝阻在家中因定向障碍而从事活动,和本地化的困难,识别和操纵对象。人们与更常见的,以记忆为主导的阿尔茨海默病表现出更多基于记忆的困难,参与活动,如忘记计划的活动,在哪里找到活动所需的项目和所涉及的步骤。尽管这些明显的症状导致的挑战,所有参与者及其家庭成员在进行创造性适应以支持持续参与日常活动方面表现出机智和韧性,更广泛地支持广泛报道的阿尔茨海默型痴呆症患者的管理策略。
    结论:这些发现为痴呆相关的视觉和记忆障碍对日常活动参与的一些不同影响提供了有益的见解。这将有助于其他人应对这些挑战,以及与受这些条件影响的人一起工作的健康和社会护理从业者。研究结果还强调了日常活动参与中涉及的众多个人和环境因素的巨大个体差异,并建议未来工作的重要领域,这些方法在生态有效性和可及性方面与此处使用的以家庭为重点的人种学方法相似。
    BACKGROUND: Supporting ageing in place, quality of life and activity engagement are public health priorities for people living with dementia, but little is known about the needs and experiences of community-dwelling people with rarer forms of dementia with lesser known symptoms. Posterior cortical atrophy (PCA) is a rare form of dementia usually caused by Alzheimer\'s disease but which is characterised by diminished visual processing (rather than a dominant memory problem), which poses challenges for maintaining independence and accessing appropriate support.
    METHODS: This study used a comparative qualitative design and focussed ethnographic methods to explore experiential differences in activity engagement for 10 people with the most common, memory-led presentation of Alzheimer\'s disease and 10 people with posterior cortical atrophy within their everyday home environments.
    RESULTS: While the data collection revealed much rich variation in individual and contextual factors, some tentative high-level differences in the experiences of everyday activities could be drawn out, seemingly attributable to the different diagnoses\' differing dominant symptoms. These included people with posterior cortical atrophy being less likely to use environmental cues to initiate activities, and more likely to withhold from asking for support because of preserved insight into the impact of this on carers. This lack of initiation of activities could be misinterpreted as apathy. People with posterior cortical atrophy also were discouraged from engaging in activities by disorientation within the home, and difficulties localising, identifying and manipulating objects. People with the more common, memory-led presentation of Alzheimer\'s disease exhibited more memory-based difficulties with engaging with activities such as forgetting planned activities, where to locate the items required for an activity and the steps involved. Despite these distinct symptom-led challenges, all participants and their family members demonstrated resourcefulness and resilience in making creative adaptations to support continued engagement in everyday activities, supporting the widely reported management strategies of people with dementia of the Alzheimer\'s type more generally.
    CONCLUSIONS: These findings offer helpful insights into some the differing impacts dementia related visual and memory impairments can have on everyday activity engagement, which will be helpful for others navigating these challenges and the health and social care practitioners working with people affected by these conditions. The findings also highlight the vast individual variation in the multitude of individual and contextual factors involved in everyday activity engagement, and suggest important areas for future work utilising methods which are similarly high in ecological validity and accessibility as the home-based focussed ethnographic methods utilised here.
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  • 文章类型: Journal Article
    背景:神经认知和精神疾病已被证明,与普通人群相比,它们与特发性正常压力脑积水(iNPH)合并的频率更高。然而,尚未评估这些疾病与iNPH之间的潜在因果关系.因此,我们的研究旨在基于双向孟德尔随机化(MR)分析,探讨二者之间的因果关系.
    方法:进行逆方差加权(IVW)方法的随机效应,以获得神经认知障碍之间的因果关系,精神疾病,iNPH通过OpenGWAS数据库下载了12种神经认知和精神疾病的全基因组关联研究(GWAS)。GWAS目录,和精神病学基因组学联盟,而iNPH的GWAS数据是从FinnGen联盟第9轮发布中获得的,767例病例和375,610例欧洲血统控制。我们还使用加权中位数模型对这些显著的因果推断进行了敏感性分析,Cochrane的Q测试,MR-Egger回归,磁共振多效度残差和异常值检测和留一法分析。
    结果:对于大多数神经认知和精神疾病,它们与iNPH之间没有因果关系。我们发现iNPH(比值比[OR]=1.030,95%置信区间[CI]:1.011-1.048,p=.001)与精神分裂症风险增加有关,敏感性分析验证失败。值得注意的是,遗传预测的帕金森病(PD)与iNPH风险增加相关(OR=1.256,95%CI:1.045-1.511,p=0.015)。
    结论:我们的研究揭示了PD与iNPH风险增加相关的潜在因果效应。有必要进一步研究PD和iNPH之间的关联以及潜在的潜在机制。
    BACKGROUND: Neurocognitive and psychiatric disorders have been proved that they can comorbid more often with idiopathic normal pressure hydrocephalus (iNPH) than general population. However, the potential causal association between these disorders and iNPH has not been assessed. Thus, our study aims to investigate the causal relationship between them based on a bidirectional Mendelian randomization (MR) analysis.
    METHODS: Random effects of the inverse variance weighted (IVW) method were conducted to obtain the causal association among the neurocognitive disorders, psychiatric disorders, and iNPH. Genome-wide association studies (GWAS) of 12 neurocognitive and psychiatric disorders were downloaded via the OpenGWAS database, GWAS Catalog, and Psychiatric Genomics Consortium, whereas GWAS data of iNPH were obtained from the FinnGen consortium round 9 release, with 767 cases and 375,610 controls of European ancestry. We also conducted the sensitivity analysis in these significant causal inferences using weighted median model, Cochrane\'s Q test, MR-Egger regression, MR Pleiotropy Residual Sum and Outlier detect and the leave-one-out analysis.
    RESULTS: For most of the neurocognitive and psychiatric disorders, no causal association was established between them and iNPH. We have found that iNPH (odds ratio [OR] = 1.030, 95% confidence interval [CI]: 1.011-1.048, p = .001) is associated with increased risk for schizophrenia, which failed in validation of sensitivity analysis. Notably, genetically predicted Parkinson\'s disease (PD) is associated with increased risk of iNPH (OR = 1.256, 95% CI: 1.045-1.511, p = .015).
    CONCLUSIONS: Our study has revealed the potential causal effect in which PD associated with an increased risk of iNPH. Further study is warranted to investigate the association between PD and iNPH and the potential underlying mechanism.
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  • 文章类型: Journal Article
    目的:评估南贡达基层医院HIV/AIDS感染者中神经认知障碍的患病率和相关因素,埃塞俄比亚西北部,2023年。
    方法:基于机构的横断面研究设计。
    方法:南冈达尔基层医院,埃塞俄比亚西北部。
    方法:使用系统随机抽样技术招募了608名参与者。
    方法:使用面试官管理的问卷和医学图表综述收集数据。国际HIV痴呆量表用于筛查神经认知障碍。数据通过EPI-DATAV.4.6录入,并输出到SPSSV.21统计软件进行分析。在双变量逻辑回归分析中,将p<0.25的变量输入多变量逻辑回归分析,以确定与神经认知障碍独立相关的因素.在p<0.05的值宣布有统计学意义。
    结果:HIV阳性参与者中神经认知障碍的患病率为39.1%。在多变量逻辑回归中,较低的教育水平(调整后OR(AOR)=2.94;95%CI1.29至6.82),失业(AOR=2.74;95%CI1.29~6.84)和合并症(AOR=1.80;95%CI1.03~3.14)与神经认知障碍显著相关.
    结论:HIV相关的神经认知问题影响了超过三分之一的参与者。根据目前的研究,并存的医疗条件,失业和低教育程度与神经认知障碍风险增加相关.因此,早期发现和治疗至关重要。
    OBJECTIVE: To assess the prevalence and associated factors of neurocognitive disorder among people living with HIV/AIDS in South Gondar primary hospitals, North-West Ethiopia, 2023.
    METHODS: Institution-based cross-sectional study design.
    METHODS: South Gondar primary hospitals, North-West Ethiopia.
    METHODS: 608 participants were recruited using the systematic random sampling technique.
    METHODS: Data were collected using an interviewer-administered questionnaire and medical chart reviews. The International HIV Dementia Scale was used to screen for neurocognitive disorder. The data were entered through EPI-DATA V.4.6 and exported to SPSS V.21 statistical software for analysis. In the bivariable logistic regression analyses, variables with a value of p<0.25 were entered into a multivariable logistic regression analysis to identify factors independently associated with neurocognitive disorder. Statistical significance was declared at a value of p<0.05.
    RESULTS: The prevalence of neurocognitive disorder among HIV-positive participants was 39.1%. In multivariable logistic regression, lower level of education (adjusted OR (AOR)=2.94; 95% CI 1.29 to 6.82), unemployment (AOR=2.74; 95% CI 1.29 to 6.84) and comorbid medical illness (AOR=1.80; 95% CI 1.03 to 3.14) were significantly associated with neurocognitive disorder.
    CONCLUSIONS: HIV-associated neurocognitive problems affected over a third of the participants. According to the current study, comorbid medical conditions, unemployment and low educational attainment are associated with an increased risk of neurocognitive disorder. Therefore, early detection and treatment are essential.
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  • 文章类型: Journal Article
    支持老化到位,生活质量,和活动参与是痴呆症患者的公共卫生优先事项。对于长期护理的痴呆症患者来说,保持有意义的活动机会的重要性已得到广泛认可,但是人们对活动的意义知之甚少,以及他们是如何经历的,患有不同类型痴呆症的人在自己的家中。这项研究使用了集中的人种学方法来探索10名记忆主导的阿尔茨海默病患者和10名患有后皮质萎缩的患者的家庭中日常活动参与的动机和意义。虽然参与者与日常环境的互动受到诊断的挑战,他们都在寻找通过各种活动继续创造意义的方法。主要发现包含在三个主题中:(1)活动的乐趣和功能;(2)护理互惠,(3)(不断变化的)自我的构成和连续性。持续参与有趣和功能性活动,为参与者提供了与不同痴呆症患者联系的机会,提供护理和支持(以及接受),保持自我和认同感。讨论了有关开发和提供量身定制的干预措施和支持的含义,以使社区中不同类型的痴呆症患者能够继续参与有意义的活动。
    Supporting ageing in place, quality of life, and activity engagement are public health priorities for people with dementia. The importance of maintaining opportunities for meaningful activities has been widely acknowledged for those with dementia in long-term care, but little is known about what makes activities meaningful for, and how they are experienced by, people with different types of dementia in their own homes. This study used focussed ethnographic methods to explore the motivations and meanings of everyday activity engagement within the homes of 10 people with memory-led Alzheimer\'s disease and 10 people with posterior cortical atrophy. While participants\' interactions with their everyday environments were challenged by their diagnoses, they were all finding ways to continue meaning-making via various activities. The main findings are encapsulated in three themes: (1) The fun and the function of activities; (2) Reciprocities of care, and (3) The constitution and continuity of (a changing) self. Ongoing engagement with both fun and functional activities offered participants living with different dementias opportunities to connect with others, to offer care and support (as well as receive it), and to maintain a sense of self and identity. Implications are discussed regarding the development and delivery of tailored interventions and support to enable continued engagement in meaningful activities for people with different types of dementia living in the community.
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  • 文章类型: Journal Article
    目的:随着医疗水平的提高,老年患者的数量正在增加,患者的术后结局不容忽视。然而,术前心率变异性(HRV)与围手术期神经认知障碍(PND)之间的关系尚未有研究.本研究的目的是探讨(HRV)和(PND)之间的相关性。术后重症监护病房(ICU),非心脏手术患者的住院时间。
    方法:这项回顾性分析包括2021年1月至2022年1月在我们六个科室接受24小时动态心电图检查的687名住院患者。根据心率变异性(HRV)将患者分为两组:高和低。使用单因素分析筛选围手术期结局的可能危险因素,并将危险因素纳入多因素logistic回归,筛选独立危险因素。进行亚组分析以评估结果的稳健性。构建了PND多因素Logistic预测模型的列线图。绘制受试者工作特性(ROC)曲线,并通过自举重新采样1000次绘制校准曲线进行内部验证,以评估列线图的预测能力。
    结果:共纳入687例符合条件的患者。低HRV发生率为36.7%,PND发生率为7.6%。低HRV组PND发生率高于高HRV组(11.8%vs5.2%),术后ICU转移率较高(15.9%比9.3%P=0.009),住院时间更长[15(11,19)vs(13),0.015].多变量logistic回归分析显示,在调整其他因素后,低HRV降低被确定为PND发生的独立危险因素(调整后赔率=2.095;95%置信区间:1.160-3.784;P=0.014)和术后ICU入住(调整后赔率=1.925;95%置信区间:1.128-3.286;P=0.016).本研究绘制了多元逻辑回归模型的列线图,纳入年龄和HRV。校正曲线表明,模型对心脑血管事件发生的预测值与实际观测值吻合较好,C指数为0.696(95%CI:0.626~0.766)。亚组分析显示,低HRV是胃肠道手术患者发生PND的独立危险因素,年龄≥65岁。
    结论:在接受非心脏手术的患者中,低HRV是PND及术后转ICU的独立危险因素,低HRV患者的住院时间延长。通过建立PND发生的风险预测模型,围手术期可以识别高危患者进行早期干预。
    OBJECTIVE: With the improvement of medical level, the number of elderly patients is increasing, and the postoperative outcome of the patients cannot be ignored. However, there have been no studies on the relationship between preoperative heart rate variability (HRV) and Perioperative Neurocognitive Disorders (PND). The purpose of this study was to explore the correlation between (HRV) and (PND), postoperative intensive care unit (ICU), and hospital stay in patients undergoing non-cardiac surgery.
    METHODS: This retrospective analysis included 687 inpatients who underwent 24-hour dynamic electrocardiogram examination in our six departments from January 2021 to January 2022. Patients were divided into two groups based on heart rate variability (HRV): high and low. Possible risk factors of perioperative outcomes were screened using univariate analysis, and risk factors were included in multivariate logistic regression to screen for independent risk factors. The subgroup analysis was carried out to evaluate the robustness of the results. The nomogram of PND multi-factor logistic prediction model was constructed. The receiver operating characteristic (ROC) curve was drawn, and the calibration curve was drawn by bootstrap resampling 1000 times for internal verification to evaluate the prediction ability of nomogram.
    RESULTS: A total of 687 eligible patients were included. The incidence of low HRV was 36.7% and the incidence of PND was 7.6%. The incidence of PND in the low HRV group was higher than that in the high HRV group (11.8% vs 5.2%), the postoperative ICU transfer rate was higher (15.9% than 9.3%P = 0.009), and the hospital stay was longer [15 (11, 19) vs (13), 0.015]. The multivariable logistic regression analysis showed that after adjusting for other factors, decreased low HRV was identified as an independent risk factor for the occurrence of PND (Adjusted Odds Ratio = 2.095; 95% Confidence Interval: 1.160-3.784; P = 0.014) and postoperative ICU admission (Adjusted Odds Ratio = 1.925; 95% Confidence Interval: 1.128-3.286; P = 0.016). This study drew a nomogram column chart for a multivariate logistic regression model, incorporating age and HRV. The calibration curve shows that the predicted value of the model for the occurrence of cardio-cerebrovascular events is in good agreement with the actual observed value, with C-index of 0.696 (95% CI: 0.626 ~ 0.766). Subgroup analysis showed that low HRV was an independent risk factor for PND in patients with gastrointestinal surgery and ASA Ⅲ, aged ≥ 65 years.
    CONCLUSIONS: In patients undergoing non-cardiac surgery, the low HRV was an independent risk factor for PND and postoperative transfer to the ICU, and the hospitalization time of patients with low HRV was prolonged. Through establishing a risk prediction model for the occurrence of PND, high-risk patients can be identified during the perioperative period for early intervention.
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  • 文章类型: Journal Article
    目的:评估神经认知障碍(NCD)对70岁或以上实体癌患者12个月总死亡率的预后价值。
    方法:前瞻性,观察,多中心队列。
    方法:我们分析了来自ELCAPA纵向多中心观察队列的70岁或以上患者的数据,在1月31日之间进行新的癌症治疗方式之前进行老年评估(GA),2007年12月29日,2017.我们在四类中定义了基线NCD:无NCD,轻度NCD,中度非传染性疾病,和主要的NCD,根据简易精神状态检查(MMSE)成绩,记忆抱怨,和日常生活工具活动(IADL)评分。
    方法:我们根据NCD类别比较了患者的基线特征,全局和成对(带有Bonferroni\'校正)。通过使用单变量然后多变量12个月生存分析来分析NCD类别的预后值,以年龄为时间变量,并且有或没有调整治疗策略(治愈,姑息性或排他性支持性护理)。
    结果:纳入2784例实体癌患者,中位数[四分位数范围]年龄为82[78;86]。36%的患者无NCD,34%有轻度NCD,17%有中度非传染性疾病,13%有严重的非传染性疾病。我们确定了以下12个月总死亡率的独立预后因素:NCD(主要NCD的校正风险比(aHR)[95%置信区间(CI)]=1.54[1.19-1.98](p<0.001),癌症的类型,转移状态,住院会诊,一般健康状况差(评估为疲劳程度和东部肿瘤协作组表现状况[ECOG-PS]),更大的体重减轻,姑息治疗,和独家支持性护理。对治疗策略的额外调整并未显著改变主要非传染性疾病与12个月总死亡率的关联强度(HR[95CI]=1.78[1.39-2.29](p<0.001)。
    结论:我们的结果表明,主要NCD的存在具有直接的预后价值(与其他老年因素无关,癌症的类型和治疗策略)在患有实体癌的老年患者中。
    OBJECTIVE: To assess the prognostic value of neurocognitive disorder (NCD) for 12 month-overall mortality in patients aged 70 or more with a solid cancer.
    METHODS: prospective, observational, multicenter cohort.
    METHODS: We analyzed data from the ELCAPA longitudinal multicenter observational cohort of patients aged 70 or over, referred for a geriatric assessment (GA) before a new cancer treatment modality between January 31st, 2007, and December 29th, 2017. We defined the baseline NCD in four classes: no NCD, mild NCD, moderate NCD, and major NCD, based on the Mini-Mental State Examination (MMSE) score, memory complaint, and the Instrumental Activities of Daily Living (IADL) score.
    METHODS: We compared the baseline characteristics of patients according to NCD classes, globally and by pairs (with Bonferroni\' correction). Prognosis value of NCD classes were analysed by using univariable and then multivariable 12 month survival analysis with age as time-variable and with and without adjustement for the treatment strategy (curative, palliative or exclusive supportive care).
    RESULTS: 2784 patients with solid-cancer were included, with a median [interquartile range] age of 82 [78;86]. 36% of the patients were free of NCD, 34% had a mild NCD, 17% had a moderate NCD, and 13% had a major NCD. We identified the following independent prognostic factors for 12 month-overall mortality: NCD (adjusted hazard ratio (aHR) [95% confidence interval (CI)] for a major NCD = 1.54 [1.19-1.98] (p < 0.001), type of cancer, metastatic status, inpatient consultation, poor general health (assessed as the level of fatigue and Eastern Cooperative Oncology Group performance status [ECOG-PS]), greater weight loss, palliative treatment, and exclusive supportive care. Additional adjustment for the treatment strategy did not greatly change the strength of the association of a major NCD with 12 month-overall mortality (HR [95%CI] = 1.78 [1.39-2.29] (p < 0.001).
    CONCLUSIONS: Our results suggest that the presence of a major NCD has direct prognostic value (independently of other geriatric factors, the type of cancer and the treatment strategy) in older patients with a solid cancer.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:简易精神状态检查(MMSE)是神经认知障碍的主要筛查和随访测试。在法国,它通常由医学生管理。允许管理MMSE的条件是严格的,但学生不知道,导致得分失误。我们的目标是评估多模式培训对医学生管理MMSE的能力的影响,并描述他们以前的培训。
    方法:纳入研究4至6年的75名医学生。先前的MMSE培训通过标准化问卷进行评估。用于我们培训的教材是用法语验证MMSE的文章,一个视频解释了如何管理MMSE测试的步骤,和MMSE的评分练习。管理MMSE的能力通过标准化实践考试(SPE)进行评估。学生自选,然后分为两组,一个受益于SPE之前的所有培训,而另一个只收到SPE之前的文章。
    结果:41名学生被纳入训练组,34名被纳入对照组。关于以前的训练,组间没有差异。71%的学生已经进行了MMSE测试,只有17%的学生接受了特定的培训。在大多数情况下,学生认为他们以前的培训是不够的。训练组的总分和SPE各子部分的得分均明显高于对照组(总分:中位数[IQR]:71[62-78]vs.52[41-57],p<0.001)。与对照组相比,训练组学生能够完成MMSE的比率更高(85%vs.44%,p<0.001)。所有参与者都认为培训的质量及其有用性良好或非常好。
    结论:多模式训练提高了医学生管理MMSE的能力。
    BACKGROUND: The Mini-Mental State Examination (MMSE) is the main screening and follow-up test for neurocognitive disorders. In France, it is often administered by medical students. Conditions allowing to administer the MMSE are strict but not well known by students, leading to mistakes in scoring. Our objectives were to assess the effect of a multimodal training on medical students\' ability to administer the MMSE and to describe their previous training.
    METHODS: 75 medical students between the 4th and 6th year of study were included. Previous MMSE training was assessed by a standardized questionnaire. The teaching material used for our training was the article validating MMSE in French, a video explaining the steps on how to administer the MMSE test, and MMSE\'s scoring exercises. The ability to administer the MMSE was assessed by a Standardized practical exam (SPE). Students were self-selected and then assigned in two groups, one benefiting from all the training before SPE, and the other receiving only the article before SPE.
    RESULTS: 41 students were included in the training group and 34 in the control group. There was no difference between groups regarding previous training. 71% of the students had already administered a MMSE test and only 17% had received specific training. Students considered their previous training as insufficient in most cases. The overall score and scores of each subpart of the SPE were significantly higher in the training group than in the control group (overall score: median [IQR]: 71 [62-78] vs. 52 [41-57], p < 0.001). The rate of students able to complete the MMSE was higher in the training group compared to the control (85% vs. 44%, p < 0.001). Quality of the training and its usefulness were judged to be good or very good by all participants.
    CONCLUSIONS: A multimodal training improves the ability of medical students to administer the MMSE.
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  • 文章类型: Journal Article
    执行功能(EF)是日常生活工具活动(IADL)的核心。评估EF困难对IADL的影响的一种新颖方法可能是通过在实验室公寓中执行IADL启发的任务时产生的言语行为。言语行为可以充当在任务执行期间遇到的困难的窗口。
    我们的目标是1)定性描述患有轻度神经认知障碍(轻度NCD)和健康对照(HC)的参与者在实验室中执行4项IADL启发的任务时产生的言语行为-公寓,然后2)比较它们在两组中的使用。
    参与者的表演被录像,产生的言语行为被转录。对所有言语行为进行了定性描述,其次是数据的演绎归纳模式编码。进行了统计分析,以进一步比较轻度NCD参与者和HC的使用情况。
    22名参与者参加了这项研究(n轻度NCD=11;nHC=11)。从模式编码中出现的数据的元类别:策略,障碍,reactions,和后果。与HC相比,轻度NCD参与者使用的策略和障碍明显更多。他们对自己的表现更有防御性,对他们的困难比HC更有反应。轻度非传染性疾病参与者完成所有任务的验证效率低于对照组。
    对实验室公寓中IADL启发的任务执行过程中产生的言语行为进行评估可以检测语言使用的变化,这可能反映了与认知能力下降有关的EF困难。
    UNASSIGNED: Executive functions (EF) are central to instrumental activities of daily living (IADL). A novel approach to the assessment of the impact of EF difficulties on IADL may be through the speech acts produced when performing IADL-inspired tasks in a laboratory-apartment. Speech acts may act as a window to the difficulties encountered during task performance.
    UNASSIGNED: We aim to 1) qualitatively describe the speech acts produced by participants with mild neurocognitive disorder (mild NCD) and healthy controls (HC) as they performed 4 IADL-inspired tasks in a laboratory-apartment, and to then 2) compare their use in both groups.
    UNASSIGNED: The participants\' performance was videotaped, and speech acts produced were transcribed. Qualitative description of all speech acts was performed, followed by a deductive-inductive pattern coding of data. Statistical analyses were performed to further compare their use by mild NCD participants and HC.
    UNASSIGNED: Twenty-two participants took part in the study (n mild NCD = 11; n HC = 11). Meta-categories of data emerged from pattern coding: strategies, barriers, reactions, and consequences. Mild NCD participants used significantly more strategies and barriers than did HC. They were more defensive of their performance, and more reactive to their difficulties than HC. Mild NCD participants\' verification of having completed all tasks was less efficient than controls.
    UNASSIGNED: An assessment of speech acts produced during the performance of IADL-inspired tasks in a laboratory-apartment may allow to detect changes in the use of language which may reflect EF difficulties linked to cognitive decline.
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